Chronic hypertension treatment in pregnancy improves fetal and maternal outcomes: Study
Egypt: The use of antihypertensive drug labetalol in pregnant women with chronic hypertension, was associated with higher rates of neonatal hyperbilirubinemia, neonatal hypotension, and higher rates of SGA, suggests a recent study. According to the study, published in the journal Hypertension in Pregnancy, treatment of mild to moderate chronic hypertension during pregnancy is beneficial for reducing both fetal and maternal morbidity.
Mohamed Rezk, Menoufiya University, Shibin Al Kawm, Egypt, and colleagues assessed the fetal and maternal outcome in women with mild to moderate chronic hypertension on antihypertensive drug (methyldopa or labetalol) therapy compared to no medication.
The multicenter randomized clinical study included 486 pregnant women wit mild to moderate chronic hypertension. They were randomized into three groups: methyldopa group (n = 164), labetalol group (n = 160), and control or no medication group (n = 162). They were followed from the beginning of the pregnancy till the end of puerperium to record maternal and fetal outcome.
Key findings of the study include:
- There was a highly significant difference between treatment groups (methyldopa and labetalol) and control group regarding the development of maternal severe hypertension, development of preeclampsia, renal impairment, presence of ECG changes, placental abruption, and repeated admission to hospital for blood pressure control with higher occurrence in the control (no treatment) group.
- Neonates in the labetalol group were more prone for the development of small for gestational age (SGA), neonatal hypotension, neonatal hyperbilirubinemia, and admission to NICU than their counterparts in the methyldopa and control groups.
- The rate of prematurity was significantly higher in the control group than the treatment groups.
"Treatment of mild to moderate chronic hypertension during pregnancy is beneficial in decreasing both maternal and fetal morbidity. The use of labetalol was associated with higher rates of SGA, neonatal hypotension, and neonatal hyperbilirubinemia compared to methyldopa or no medication," concluded the authors.
"Methyldopa versus labetalol or no medication for treatment of mild and moderate chronic hypertension during pregnancy: a randomized clinical trial," is published in the journal Hypertension in Pregnancy.